EFFECTS OF INITIAL BMI AND ON-TREATMENT WEIGHT CHANGE ON THE LIPID-LOWERING EFFICACY OF FIBRATES

OBJECTIVE: To assess the effects of BMI at baseline and on-treatment w eight change on the lipid-lowering efficacy of diet plus fibric acid d erivatives (fibrates) in hypercholesterolemic adults. SUBJECTS: 6003 p articipants in a Belgian General Practitioners Trial, an open-label, p rospective study conducted in a primary care setting. MEASURES: Effect of initial BMI, on-treatment weight change, or lipid values at baseli ne on percentage changes in low-density lipoprotein cholesterol (LDL-C ), high-density lipoprotein cholesterol (HDL-CI, and triglycerides (TG ). Multiple linear regression models, including initial BMI, on-treatm ent weight change, age, gender, and baseline lipid values, were fitted to control the influences exerted by these variables on each other. R ESULTS: Reductions in LDL-C after diet plus fibrate treatment for 12 w eeks were inversely related to initial BMI and to TG levels at baselin e, and were positively associated with baseline LDL-C concentrations a nd with on-treatment weight change (P < 0.001 for all analyses). Decre ases in TG related negatively with initial BMI (P = 0.012), and positi vely with weight loss (P = 0.011) and TG at baseline (P < 0.001). Incr eases in HDL-C were negatively associated with initial BMI (P = 0.012) and with baseline TG (P < 0.001). CONCLUSIONS: The LDL-C towering eff icacy of fibrates is inversely related to initial BMI, and is positive ly associated with on-treatment weight loss.